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目的探讨320排CT血管成像技术在血管性耳鸣诊断、治疗方案选择及手术预后中的临床意义。方法用320排CT对血管性耳鸣的患者进行CTA+CTV检查,根据320排CT血管成像结果是否有明显血管异常进行相应处理,有血管异常组则进行责任血管的处理,无血管异常组行颈内静脉高位结扎,对术前、术后耳鸣症状评分并随访。结果血管畸形组在术后1个月、术后1年耳鸣评分显著低于术前(均P<0.01);无血管畸形组在术后1个月、术后1年耳鸣评分也显著低于术前(均P<0.01)。在治疗前,血管畸形组略高于无血管畸形组,但两组差异无统计学意义(P>0.05);血管畸形组术后第1天、术后1个月及术后1年耳鸣评分均低于无血管畸形组(均P<0.05)。血管畸形组中有2例颞骨CT平扫显示无明显乙状窦优势,但CTA+CTV检查病变侧乙状窦优势,行乙状窦整复术疗效佳,另有1例患者颞骨CT无特殊发现,而CTA+CTV检查动静脉瘘行介入栓塞治疗后疗效佳。结论 320排CT血管成像技术可以作为血管相关性耳鸣诊断的重要检查方法,能为血管搏动性耳鸣手术方式的选择及预后提供重要依据。
Objective To investigate the clinical significance of 320-slice CT angiography in the diagnosis of vascular tinnitus, treatment options and surgical prognosis. Methods CTA + CTV was performed in 320 patients with vascular tinnitus by using 320-slice CT. According to the results of 320-slice CT angiography, whether there was any significant vascular abnormalities, the patients with vascular abnormalities were treated with responsible vessels. The vessels without vascular anomalies High ligation of the internal veins, preoperative and postoperative tinnitus symptom score and follow-up. Results The level of tinnitus 1 month after operation and 1 year after operation in vascular malformation group was significantly lower than that before operation (all P <0.01). One month after operation and 1 year after operation, the tinnitus score of vascular malformation group was significantly lower than that of preoperative Preoperative (all P <0.01). Before treatment, vascular malformation group was slightly higher than without vascular malformation group, but there was no significant difference between the two groups (P> 0.05); vascular malformation group 1 day after surgery, 1 month after surgery and 1 year after the tinnitus score All were lower than those without vascular malformations (all P <0.05). In the vascular malformation group, 2 cases of temporal bone CT showed no obvious sigmoid sinus superiority, but CTA + CTV showed the superiority of the lateral sigmoid sinus and the sigmoid sinus surgery, and 1 case had no temporal bone CT Found, and CTA + CTV examination arteriovenous fistula intervention after embolization curative effect is good. Conclusion 320-slice CT angiography can be used as an important method for the diagnosis of vascular-related tinnitus. It can provide an important basis for the selection and prognosis of vascular pulsatile tinnitus surgery.